National Health Standards Act

Summary

National Health Standards Act - Title I: Health Benefits for Employees - Requires employers to provide employees and their families with an approved health care plan. Allows existing health plans to expire before a plan under this Act is required. Limits employer contributions to such plans to 50 percent of the cost. Sets forth mandatory services under such plans, including: inpatient hospital services, physicians services, medical supplies in connection with hospitalization or surgery, prescription drugs, lab and X-ray services, and psychiatric care. Excludes from such plans expenses for eyeglasses, orthopedic shoes, cosmetic surgery, custodial care, dentistry, hearing aid, and general physical examinations. Requires an individual or family to pay $100 per year for each individual or $200 per family per year for expenses and 25 percent of the next $10,000 of expenses per year for such services. Limits obstetrical care under the plan to 50 percent of charges up to a maximum of $500 for any one pregnancy. Prescribes penalties for employer noncompliance with this Act, including payment of all employee medical expenses during noncompliance. Sets forth requirements for hospitals and doctors in order to be paid from such plans, including utilization review. States that any employer who does not arrange with an insurance company, but makes a plan directly available to his employees shall notify the appropriate State official of the contents of his plan. Requires insurance companies making large plans available to also make plans available for small employers and the self-employed. Allows employees the option of membership in a qualified Health Maintenance Organization. Title II: Health Benefits for Low-Income Individuals and Their Dependents - Adds "Title XX - Health Benefits for Low-Income Individuals and Families" to the Social Security Act. Establishes a comprehensive medical and hospital benefits program for "low-income individuals," "low-income families," and "dependent beneficiaries" as defined by this title. Allows the payment of full premiums for a health care plan for qualified individuals. Sets forth minimal payments, based on income, of those not qualifying for full premium payment. Requires the payment to States of 100 percent of health care costs under this title. Describes mandatory services, excluded services, and doctor and hospital requirements under this title which are similar to those under title I. Requires each beneficiary under this title to pay 10 percent of the cost of each service, not to exceed 5 percent of annual income. Prohibits participation by an insurance company under this Act unless such company develops health care policies which may be purchased for individuals and families under this title. Requires States to contract with an insurance company (or companies) to pay for services to beneficiaries under this title. Title III: General Provisions - Establishes in the Executive Office of the President a Council of Health Advisers to appraise health programs of the Federal Government. States that the insurance pools authorized in this Act shall be administered by the administering carrier under regulations of the appropriate State agency, and shall pay all State plan benefit claims certified by the administering carrier. Repeals Title XIX - "Grants to States for Medical Assistance Programs" under the Social Security Act.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

1. 11 April 1974

   Introduced

   Referred to Senate Committee on Finance.

   Source: IntroReferral

2. 11 April 1974

   Introduced

   Introduced in Senate

   Source: IntroReferral

Votes

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Versions

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Documents

1 official file

• Introduced in Senate

  summary · EN · 11 April 1974

  Open at official source

Sponsors

• Sen. Fannin, Paul J. [R-AZ] · R · Sponsor
• · ssfi00 · Standing

Related records

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